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4.3 Pathological changes in the liver caused by arsenic trioxide 4.3.1 Inflammatory mechanism Enhanced oxidative stress results in inflammation and the generation of pro-inflammatory cytokines, such as interleukin 6 (IL-6), interleukin 1 (IL-1), and tumor necrosis factor-alpha (TNF-), causing the disruption of the biological membrane ( 4.3.2 Fibrosis mechanism The networks of inflammation, cell death, and HSC activation mutually influence each other, resulting in initial hepatic steatosis and, with prolonged arsenic exposure, eventual portal fibrosis (Santra et al., 2000)

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